肿瘤相关巨噬细胞在鼻咽癌中的功能机制及治疗研究进展

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中图分类号：R739.62 文献标志码：A DOI：10.3969/j.issn.1007-7146.2025.06.004

Abstract： Nasopharyngeal carcinoma （NPC） is a highly prevalent malignant tumor in Southeast Asia and Southern China， withastrong asociationwithEpstein-Barrvirus （EBV）infection.Althoughearly-stageNPCexhibitsfavorablelocalcontrol withchemoradiotherapy，recurrence，metastasis，anddrugresistanceremain majorclinical chalenges.Immunecelsplaya critical role in tumor progression，among which macrophages—originating from bone marrow hematopoietic stemcells （differentiatedviamonocytes）—serveasorecomponentsofinnateimmunitywidelydistributedintissues togulate inflammationandtisserepair.Tumor-asociatedmacrophages（TAMs），acentralconstituentof thetumormicroenvironment， are recruited and diferentiatedfrom monocytes by tumor-secreted cytokines，displaying high plasticitywith two primary subtypes： pro-tumor M2 andanti-tumor M1.M2-typeTAMs drivetumor progressionby promoting proliferation，invasion， angiogenesis，andimmunosuppression，.g.，verexpressingprogrammeddeath-ligand1（D-L1）andsecretinginterleuki-10 （IL-10）. Incontrast，M-typeTAMsexertdiretanti-tmorefects troughantibody-dependentcellarcytotoxicity（ADCC）， reactive oxygen species/nitricoxide （ROS/NO）-induced apoptosis，andactivation ofadaptive immunity via enhancedantigen presentation and CD8+ T-cell infiltration. Clinical studies indicate that high infiltration ofM2-type TAMs correlates with reducedpatientsuival，chemoradiotherapyesistance，anddminishedimmunotherapyesponse，highlightingtheirotetialas prognostic biomarkers and therapeutictargets.Curent terapeutic strategies targeting TAMs include：inibiting M2recruitment byblocking the CCL2-CCR2/CSF-1R signaling axis; enhancing M1 function viaepigeneticregulationor CD40bispecific antibodies;depleting pro-tumor TAMs using clodronate liposomes or photothermal/photodynamic therapy; and combining withchemoradiotherapyormmunotherapy.Tisarticlesstematicallyeviestheogin，lasification，fuctionsndical relevanceofTAMsinNC，ummarzesadvancementsintargetedterapeuticstrategiesandprovidesteoreticalandpractical insights for individualized NPC treatment.

KeyWords： nasopharyngealcarcinoma; tumor-asociated macrophages;tumormicroenvironment; macrophagepolarization; targeted therapy

（ActaLaserBiology Sinica，2025，34（6）：504-514）

鼻咽癌是起源于鼻咽上皮的恶性肿瘤，具有显著的地域与种族分布特征，全球约 80% 的病例集中于中国南方（如广东、广西）及东南亚地区[1]。（剩余23770字）